The physician-scientist workforce has been an important driver for many of the substantial discoveries in medicine and health-care over the last two decades. Yet, the pipeline of clinician-scientist trainees has been in decline, fueled by complexity and requirements of clinical training, mounting debt after medical school, declining NIH paylines, and importantly, lack of access to research mentorship during clinical training. After four or more years of residency training with little time or support for research endeavors, there are many hurdles for research-oriented trainees to initiate or re-initiate research. This represents a major gap in the development of physician-scientists prepared to translate research into the clinical arena during their careers. The primary goal of the multidisciplinary Duke Scientist-Clinician-Investigator Stimulating access to Research during Residency (Duke SCI-StARR) program is to train physician-scientists in all aspects of biomedical research in order to cultivate investigators who will lead the development, implementation, and evaluation of new clinical modalities to prevent, diagnose, and treat disease states affecting the heart, lungs, and blood. Duke SCI-StARR will train residents across 3 departments: Pediatrics, Medicine, and Surgery in areas along the full biomedical research continuum (basic/translational, early phase clinical trials and pharmacokinetics, and late phase clinical trials and outcomes) with a theme of improving health over the life course. The program will consist of four training aims: 1) comprehensive didactics covering basic, translational, and clinical research and professional development; 2) development and completion of a research project and an individualized career development plan; 3) establishment of a track record of scholarly activity; and 4) eligibility for board certification and continuation to subspecialty training. Duke SCI-StARR will be led by an Executive Committee (EC) of MPIs Sallie Permar, MD, PhD (Pediatrics), Scott Palmer, MD, MHS (Medicine), and David Harpole, Jr, MD (Surgery), and a SCI-StARR Associate Program Director from each department, along with an Expanded EC of Residency Program Directors and Program Coordinators, capitalizing on a team of 23 multi-departmental, multi-disciplinary, well-funded, and experienced faculty preceptors. This application requests support for three Resident-Investigators each year with each trainee to be supported for 18-24 months of research. Upon completion of the program, these individuals will be capable of transitioning to research-intense fellowship training, successfully competing for extramural funding to support a path to independence as physician-scientists, and becoming the next generation of physicians leading and mentoring trainees in clinically-oriented research of disease states affecting the heart, lungs, and blood. Acheivement of the program's objectives will fulfill urgent medical needs for: 1) more full-time academic physician-researchers and mentors in medical schools throughout the country and 2) innovations and clinical translation of novel strategies to improve the health of individuals across the life course.